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Articles/Sex During Pregnancy: Is It Safe?

Sex During Pregnancy: Is It Safe?

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Dr Len Kliman Associate Professor
10mins mins read February 21st 2022
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If you have a normal straightforward pregnancy and no past history of significant obstetric complications, intercourse is safe during pregnancy. You may read on Google that semen contains substances called prostaglandins and that these can initiate or trigger labour. Similarly, the pituitary hormone oxytocin has also been associated with premature delivery.

However, there are numerous studies showing that the presence of these hormones in association with intercourse does not increase the risk of premature labour in otherwise normal pregnancy and the presence of these substances pose a theoretical risk that has never been shown to be an actual risk.

Although, if you have a complication in this pregnancy or have had a significant complication noted in a previous pregnancy you may be told by your obstetrician to avoid intercourse.

These include a past history of:

  • Premature delivery
  • The presence of a low placenta
  • A condition called placenta previa
  • The presence of a stitch in the cervix called a cervical suture or recurrent unexplained bleeding
Should You Use a Condom?

The only purpose of using a condom would be if your partner had a known infection that can be associated with complications in pregnancy. This especially is the case where your partner is known to have herpes simplex, a virus that can be passed on via sexual intercourse and can cause complications during pregnancy.

If a pregnant woman has a primary or first infection during pregnancy the virus is then present in the bloodstream of the pregnant woman and can cross the placenta. If the pregnant woman develops a secondary infection that is it is not her first infection, then the presence of the virus adjacent to the birth canal in the case of genital herpes can result in a newborn developing a significant herpes infection via direct contact. Rarer asymptomatic infections in the male partner such as mycoplasma or ureaplasma are an occasional cause of prematurity. In the absence of infection in the male partner, a condom per se is unnecessary. Certainly, a condom is unnecessary to avoid the effect of prostaglandins or oxytocin.

Can Sex During Pregnancy Bring on Labour?

Intercourse in pregnancy in a patient who is not at risk of premature delivery either because of previous premature birth, the presence of a cervical suture or the presence of excess amniotic fluid (polyhydramnios) is not usually associated with the initiation of a premature labour. The important information is that if you have an uncomplicated pregnancy with no factors that already increase your risk of a premature delivery then intercourse is safe.

When Is Sex During Pregnancy no Longer Safe?

There is no gestation per se where intercourse is unsafe. In other words, intercourse can safely occur in a normal pregnancy where there are no factors that already increase your risk of prematurity right throughout the pregnancy, that is up until the time you come into labour.

There is no gestation per se which makes intercourse more of a concern.

As mentioned previously, intercourse should be avoided when you have had recent vaginal bleeding, you have a past history of unexplained premature delivery, you have had threatened premature delivery during this particular pregnancy, you have had unexplained vaginal bleeding either as a threatened miscarriage or after 20 weeks as an antepartum haemorrhage, or you have a cervical suture in situ.

Can Sex During Pregnancy Cause a Miscarriage?

With the exception of women who have a cervical suture in situ, intercourse per se is not a cause of miscarriage.

However, if you have had recent vaginal bleeding, intercourse that can trigger bleeding from the cervix may confuse the issue with respect to the presence of an ongoing threat of miscarriage.

The cervix in pregnancy tends to be more vascular and there is an increase in cervical gland cells exposed to the vagina. This in itself increases the risk of vaginal bleeding which can confuse the issue as to whether the threat of a miscarriage is still present. Bleeding associated with intercourse because of the physiological changes resulting in a more vascular cervix is in itself not in any way a cause of miscarriage but can confuse the issue.

What Are The Benefits of Having Sex When Pregnant?

Intercourse between couples is a normal healthy part of a relationship. Couples enjoy this aspect of their relationship and it helps to create a stronger bond and perpetuate that bond. Most couples in the presence of pregnancy want to continue their relationship as usual and have the usual level of intimacy is a part of this ongoing normal relationship.

Comfortable Sex Positions During Pregnancy

Most women find as the pregnancy proceeds lying on your back becomes more and more uncomfortable and can be associated with a drop in blood pressure and dizziness. Intercourse in this position with a large uterus can become more and more uncomfortable, so therefore the missionary position becomes less comfortable and is not recommended especially after 20 weeks.

A number of couples find that either having intercourse with both participants on their side is often more comfortable. Similarly, with the pregnant woman on top of her partner intercourse is often more comfortable and allows the pregnant woman to have more control especially if intercourse in any way has become uncomfortable. Therefore, the most comfortable and appropriate positions to have intercourse include:

  • Intercourse with both participants on their side
  • Intercourse with the pregnant women in the all-fours position or especially with a pillow or a number of pillows placed under the pregnant woman’s chest
  • Intercourse with the pregnant woman on top

There is no particular position that is unsafe during pregnancy. It is all a matter of comfort and enjoyment.

What Does Sex During Pregnancy Feel Like?

First of all, pregnant women have a great variation in their actual libido during pregnancy. There is no rhyme or reason to this but it is known that some women notice their libido is increased or heightened during pregnancy and other pregnant women notice that their libido is particularly low during pregnancy.

It is important to realise and acknowledge that each woman will have their own feelings and issues with respect to having intercourse during pregnancy.

It is important also to realise that lubrication during intercourse whilst pregnant may vary and that routine lubricants are safe to use during pregnancy either water-based or oil-based.

What If I Don’t Want To Have Sex?

It is often important early in the pregnancy to discuss this topic concerning having intercourse during pregnancy. Some women feel particularly anxious and concerned about the safety of intercourse during pregnancy and even though they may be reassured, if anxiety is an issue then obviously intercourse may not be the appropriate course of action.

The best way to avoid any issues is to have an open and frank discussion with your partner and with your treating obstetrician. Often becoming educated about all aspects of intercourse during pregnancy will allow you to proceed with intercourse with minimal or no anxiety and this in itself often helps your libido or sex drive.

In conclusion, it is important to realise that routine straightforward intercourse in a normal pregnancy where there have been no significant complications and where there have been no significant complications in previous pregnancies, is totally safe. Intercourse is obviously part of a normal relationship and there is no reason why that aspect of a normal healthy relationship cannot be continued during pregnancy.

Frequently Asked Questions About Sex During Pregnancy
  • Is sperm good for the baby?
    There is no particular advantage to the baby being exposed to sperm and similarly, there is no disadvantage to the baby being exposed to sperm.
  • Is It Safe To Have an Orgasm When Pregnant?
    It is totally safe to have an orgasm during pregnancy. Orgasm can be associated with contractions of the bladder or the uterus but a number of studies have shown that orgasm per se does not increase the risk of premature delivery and there is no reason to avoid intercourse or orgasm during pregnancy.
  • Is Bleeding After Sex Normal During Pregnancy?
    As mentioned above, the cervix becomes more vascular in normal pregnancy and also the glandular tissue of the cervix which has a tendency to bleed tends to pout out and point more towards the vagina during a normal pregnancy. For this reason, light spotting or bleeding after intercourse is particularly common. However, it is important to make sure that there is no other cause for bleeding following intercourse and you should always let your treating obstetrician know when you having bleeding following intercourse so other potential causes for this bleeding can be excluded.
  • Is It Normal To Experience Pain After or During Sex?
    Intercourse during pregnancy can be more uncomfortable or even associated with some pelvic pain. Firstly, the vagina tends to swell because of the increased blood flow to the area and to the increased tendency to retain body fluid during pregnancy. This in itself may make intercourse uncomfortable. Similarly, the vagina tends to be more sensitive during pregnancy and lubrication varies between different women, a drier vagina may make intercourse more uncomfortable. Similarly, orgasm can be associated with contractions of the uterus, bladder or vagina although these are usually short-lived. If the pain associated with having intercourse persists or is associated with bleeding, it is important that you do not ignore the pain and you notify your treating practitioner.
  • Is Masturbation Safe During Pregnancy?
    Routine masturbation including stimulation of the clitoris is safe during pregnancy as applies to the actual experience of intercourse. However, if during masturbation the cervix is knocked this can trigger harmless vaginal bleeding. It is always important to have frank and open discussions both with your partner and with your treating obstetrician. If intercourse is associated with bleeding or persistent pain it is important that you do not ignore the symptoms and just assume they have occurred due to intercourse – always notify your obstetrician so that other causes for these symptoms can be excluded.

With over 30 years experience in the field, Dr Len Kliman is highly regarded as one of Melbourne’s leading gynaecologists. He has vast experience in the diagnosis and treatment of a wide range of women’s gynaecological and vaginal issues and was recently appointed as an Associate Professor by the University of Melbourne Clinical School.

To find out more about Dr Len Kliman, or to book an appointment, get in touch with the clinic and speak to one of our highly-experienced nurses who are here to assist you with all of your gynaecological health needs.